Neural Dysregulation in Posttraumatic Stress Disorder: Evidence for Disrupted Equilibrium Between Salience and Default Mode Brain Networks
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OBJECTIVE: Convergent research demonstrates disrupted attention and heightened threat sensitivity in posttraumatic stress disorder (PTSD). This might be linked to aberrations in large-scale networks subserving the detection of salient stimuli (i.e., the salience network [SN]) and stimulus-independent, internally focused thought (i.e., the default mode network [DMN]). METHODS: Resting-state brain activity was measured in returning veterans with and without PTSD (n = 15 in each group) and in healthy community controls (n = 15). Correlation coefficients were calculated between the time course of seed regions in key SN and DMN regions and all other voxels of the brain. RESULTS: Compared with control groups, participants with PTSD showed reduced functional connectivity within the DMN (between DMN seeds and other DMN regions) including the rostral anterior cingulate cortex/ventromedial prefrontal cortex (z = 3.31; p = .005, corrected) and increased connectivity within the SN (between insula seeds and other SN regions) including the amygdala (z = 3.03; p = .01, corrected). Participants with PTSD also demonstrated increased cross-network connectivity. DMN seeds exhibited elevated connectivity with SN regions including the insula (z = 3.06; p = .03, corrected), and SN seeds exhibited elevated connectivity with DMN regions including the hippocampus (z = 3.10; p = .048, corrected). CONCLUSIONS: During resting-state scanning, participants with PTSD showed reduced coupling within the DMN, greater coupling within the SN, and increased coupling between the DMN and the SN. Our findings suggest a relative dominance of threat-sensitive circuitry in PTSD, even in task-free conditions. Disequilibrium between large-scale networks subserving salience detection versus internally focused thought may be associated with PTSD pathophysiology.
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Structural alterations in PTSD co-occur with functional brain alterations, including alterations in activation and connectivity in the amygdala, hippocampal, orbitofrontal cortex, and dorsal anterior cingulate cortex.
“These structural alterations co-occur with functional brain alterations in PTSD, which include alterations in activation and connectivity in amygdala, hippocampal, orbitofrontal cortex and dorsal anterior cingulate cortex”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [92]
Individuals with PTSD show diminished coherence across the DMN.
“as well as diminished coherence across the DMN ( Bluhm et al., 2009 ; Lanius et al., 2010a ; Sripada et al., 2012 ; for a review, see Akiki et al., 2017 ; Lanius et al., 2020 ).”
From The brain-body disconnect: A somatic sensory basis for trauma-related disorders (2022) · cites this paper as Sripada et al., 2012
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- Authors
- Sripada, R. K., King, A. P., Welsh, R. C., Garfinkel, S. N., Wang, X., Sripada, C. S., & Liberzon, I.
- Affiliations
- University of Michigan (US)
- Brighton and Sussex Medical School (GB)
- Corresponding author
- Sripada, Rebecca K.
- Sripada, Chandra S.
- ORCID
- Venue
- Psychosomatic Medicine
- Published
- 2012-11
- Volume
- 74
- Issue
- 9
- Pages
- 904-911
- ISSN
- 0033-3174 (ISSN-L)
- PMC
- PMC3498527
- OpenAlex
- W2087755851
- Cited by
- 412
- References
- 73
- Citations by year
- 2026: 18 · 2025: 18 · 2024: 30 · 2023: 26 · 2022: 24 · 2021: 33 · 2020: 43 · 2019: 41 · 2018: 41 · 2017: 31 · 2016: 30 · 2015: 33 · 2014: 24 · 2013: 18
- FWCI
- 27.28
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Psychosomatic Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- National Institute of Mental Health (R24MH075999)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- post-traumatic stress disorder, default mode network, salience network, resting-state functional connectivity, veterans, threat sensitivity, attention, rostral anterior cingulate cortex, ventromedial prefrontal cortex, insula, amygdala, hippocampus
- MeSH terms
- Adult, Brain, Brain Mapping, Cerebral Cortex, Combat Disorders, Conditioning, Psychological, Dominance, Cerebral, Emotions, Gyrus Cinguli, Homeostasis, Humans, Image Interpretation, Computer-Assisted, Magnetic Resonance Imaging, Male, Nerve Net, Reference Values, Stress Disorders, Post-Traumatic, Veterans, Prefrontal Cortex, Imaging, Three-Dimensional, Iraq War, 2003-2011, Afghan Campaign 2001-
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